BRITISH PRIME minister David Cameron has said that plans to reform the National Health Service are “a once-in-a-lifetime” opportunity to deliver world-class care to England. The plans, which will be published formally this week, have caused deep concern among doctors, nurses and health managers.
Under the programme, which is to be introduced gradually between now and 2013, general practitioners will be given command of 80 per cent of the NHS budget and freedom to negotiate contracts with hospitals and other health services. However, there are concerns this will amount to privatisation by degree.
In a joint letter yesterday, the leaders of six of the largest unions representing NHS staff, including the British Medical Association (BMA) and the Royal College of Nursing, voiced their “extreme concerns” about the Conservatives/Liberal Democrats’ plans, which were not part of either party’s election manifesto.
The plan will be announced tomorrow by the Conservative health secretary Andrew Lansley, who has responsibility for the NHS in England. The reforms will not be binding on NHS branches in Scotland, Wales or Northern Ireland – they report to local devolved administrations.
Insisting that speed is necessary, Mr Cameron, speaking in London, drew on the experiences of former Labour prime minister Tony Blair, who said in his memoirs that he should have moved much faster and further to reform public services in his first term in office, when his political capital was at its height.
Mr Lansley said enough GP practices had signed up to cover half of all England. Some management experts say the plans may work, but GPs will need to draft in outside experts to help.
Major consulting firms are already seeking a deal. KPMG, for one, has already signed a deal with NHS London to help GPs there to become “pathfinders” for the new regime.
In their letter, the BMA, Royal College of Nursing and the labour unions worried that pitching the NHS hospitals into a battle for business with private companies threatens patient care, while others have said the NHS hospitals could be challenged in the courts for contracts they do win.
Health spending has been given some protection from the spending cuts affecting the rest of the English public service, but health inflation costs are running at 4 per cent a year.
“There is no quiet life option. If we had just carried on as we are I think we would face a very big crunch in two to three years’ time,” said Mr Cameron.
“I share the burning impatience of so many who are frustrated that, in too many instances, we are asked to settle for second best. I passionately believe that it does not have to be this way. And the truth is that we won’t eliminate the scars of deep poverty and huge inequalities in our country if we go on with services as they operate today,” he added.
Meanwhile, existing NHS trusts are already making cutbacks to stay within budget. In Greater Manchester, patients have been told that 57 different types of operations have been put off until April, or perhaps longer.
A leaflet explaining the changes to patients says: “Carrying out operations that are not of great health benefit uses up resources that could be spent on really making a difference elsewhere.”